Tell Me Again, What Are You Treating?

Traditional medicine works this way: patient has symptoms, physician performs exam and tests, diagnosis is established, and treatment is initiated. Simple enough, right?

More and more ophthalmologists are managing patients without symptoms, with normal or near-normal exams, and recommending treatments because they might have a problem.

This is the conundrum of Glaucoma Suspects, individuals who do not have active glaucoma but exhibit so many risk factors for the disease that doctors refuse to wait. Such impatience makes a great deal of sense because the damage that occurs once glaucoma begins is irreversible.

Chronic elevated pressure from untreated glaucoma permanently destroys the delicate nerve fibers that transmit the visual signal from the eye to the brain. The eye cannot regenerate these nerve fibers or make new fibers - they are gone forever! Patients are unaware that their intraocular pressure is abnormally high and visual symptoms typically do not emerge until very late in the disease.

Rather that wait for the patient to present with advanced glaucoma, eye specialists have decided to treat individuals with changes suggestive for glaucoma -- even if the vision is 20/20 and visual field testing is normal. Some of these warning signals include:

• Family history of glaucoma
• Borderline intraocular pressures (ocular hypertension)
• Small hemorrhages near the optic nerve
• Abnormal clinical appearance to the optic nerve itself
• Unusually thin central corneas

Remember, good doctors treat patients, not numbers. Given that the damage caused by glaucoma is irreversible it makes sense to treat the condition before any damage occurs.

Related Topics:

• WebMD Video: Are You at Risk for Glaucoma?
• WebMD Video: Detecting Early Glaucoma

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